Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Nebraska for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nebraska only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Nebraska (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Amy Garwood (NPI 1649227646)

Field	Value
Entity Type	Individual
Organization	Amy Garwood
Address	7441 O St Ste 400
City	Lincoln
State	NE
ZIP	68510
Taxonomy	Rheumatology Physician
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

This provider’s billings are effectively single‑payer: Total Medicare revenue is $1.3M and there is no Medicaid billing on file, so Medicare dominates the reported payer mix. The NPI was enumerated on 2006-05-27 (~20 years ago), indicating long tenure in the Medicare program and likely established referral relationships and workflows for adult specialty care.

Revenue is highly concentrated in a small set of injectable biologics: the precomputed top 3 Medicare codes by revenue account for 78.5% of this provider's total Medicare revenue, driven principally by J3111 (51.6%), J0897 (14.7%), and J3262 (12.3%). This concentration signals dependence on a few high‑revenue drugs rather than volume from routine E/M visits or broad ancillary services.

The code mix points to a biologics/infusion‑centric rheumatology practice model: high revenue items are J3111 (romosozumab), J0897 (denosumab), and J3262 (tocilizumab), and the presence of infusion/administration codes such as 96401, 96413, and 96365 suggests on‑site administration capacity or an infusion suite. Office E/M codes (99214, 99213) together make a small share of revenue, reinforcing that drug administration rather than office visits is the primary revenue driver.

Competitive standing by code is uneven: for J3111 the provider ranks #21 of 970 nationally (98th percentile; notably above typical national volume), making them a high‑volume national outlier for that specific product. By contrast, J0897 ranks #978 of 10057 (90th percentile; typical, unremarkable volume) and J3262 ranks #367 of 618 (41th percentile; typical, unremarkable volume), indicating strong relative dominance only for selected therapies.

Several administration and injection codes show above‑typical utilization, implying operational throughput: 96372 has 469 claims and $5.2K revenue and ranks #1841 of 58224 (97th percentile; notably above typical national volume), which suggests frequent same‑visit injections or supervised administration by clinical staff. High counts for infusion/administration codes paired with the biologic drug codes are consistent with an ongoing infusion/injection workflow and staffing requirements.

Unit payment patterns are mixed: J3111 shows very large contribution to revenue with 86.9K claims and $695.5K revenue at an $8 avg paid/claim, reflecting high volume of a single product as the main revenue driver rather than high per‑unit reimbursement. Other biologics such as J0897 ($197.6K revenue, $18 avg paid/claim) and J3262 ($165.6K revenue, $5 avg paid/claim) further illustrate that revenue relies on volume and mix of biologic agents with differing avg paid/claim levels.

Ancillary oncology/infusion codes appear but contribute modestly to revenue, indicating supplementary infusion activity: 96401 (359 claims, $19K revenue) and 96413 (100 claims, $9.6K revenue) are present at ranks that are not outlier high nationally, suggesting additional but not primary chemotherapy/infusion services. This pattern supports a specialty practice that integrates biologic administration into outpatient care rather than a high‑throughput oncology infusion center.

From a contracting and network perspective, the lack of Medicaid billing ("none below") combined with concentrated Medicare biologic revenue implies this provider’s financial exposure and referral leverage are tightly tied to Medicare fee schedules and the market for specific injectable biologics. Analysts considering network inclusion or utilization management should focus on the provider’s J3111 activity (nationally high volume) and operational capacity for on‑site injections/infusions when evaluating cost and access impacts for payers.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3111	Injection, romosozumab-aqqg, 1 mg	86,940	$10	$695.5K
J0897	Injection, denosumab, 1 mg	10,980	$20	$197.6K
J3262	Injection, tocilizumab, 1 mg	33,130	$10	$165.6K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	35,200	$1	$140.8K
J1602	Injection, golimumab, 1 mg, for intravenous use	5,550	$10	$55.5K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	230	$90	$20.2K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	360	$50	$19K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	290	$60	$17.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	100	$100	$9.6K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	120	$50	$5.6K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nebraska Distribution

Amy Garwood — 3 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	5	10	56,400	$1	$414.5K
J3262	3	10	55,060	$1	$340.9K
J3111	1	10	28,140	$10	$291.3K
J1602	3	10	16,350	$10	$204.1K
J0897	10	200	2,040	$20	$62.7K
96413	40	80	60	$90	$18.2K
99214	912	3,210	110	$70	$14.9K
96401	4	30	120	$50	$11K
99213	425	3,220	90	$50	$7.9K
99204	1,261	1,320	30	$100	$5.3K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Amy Garwood, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jennifer Elliott	NE	Rheumatology Physician	$767.9K	$0
Heather Sorensen	NE	Family Nurse Practitioner	$358.2K	$0
Nicole Hansen	NE	Physician Assistant	$278.8K	$0
Kayla Bruss	NE	Physician Assistant	$166.2K	$0
Dominic Piccolo	NE	Physician Assistant	$133.2K	$0
Sherry Layman	NE	Nurse Practitioner	$58.6K	$0
Jaimie Russell	NE	Primary Care Nurse Practitioner	$23.5K	$0

Nearby Providers

Other providers in the same ZIP code as Amy Garwood, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Elizabeth Regional Medical Center	NE	General Acute Care Hospital	$0	$14.9M
St. Monica's	NE	Substance Abuse Rehabilitation Facility	$0	$7.1M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$3.9M
Centerpointe, Inc.	NE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.7M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$3.6M
Lincoln Medical Education Partnership	NE	Family Medicine Physician	$0	$3.2M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$2.9M
Lincoln-lancaster County Health Department	NE	Public Health or Welfare Agency	$0	$2.7M
Chi Health Clinic Specialty, LLC	NE	Hospitalist Physician	$0	$2.6M
Eyes On Lincoln	NE	Optometrist	$0	$2.6M

Amy Garwood — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References